title: Healthcare resource use among heart failure patients in a randomized pilot study of a cognitive training intervention.
abstract: OBJECTIVE
  To compare healthcare resource use of patients with heart failure (HF) randomized to the cognitive training intervention and to the health education active control intervention in a randomized controlled pilot study.
  
  
  BACKGROUND
  Cognitive training interventions may be efficacious and improve patients' memory and abilities to perform instrumental activities of daily living and self-care behaviors that may, in turn, lower healthcare resource use, but the influence of these interventions on healthcare resource use is unknown.
  
  
  METHODS
  Thirty-four HF patients were randomized to the computerized plasticity-based cognitive training intervention called Brain Fitness and to the health education active control intervention and completed the study. The primary outcome variable for the study was memory (recall and delayed recall). The secondary purpose of the study that is the focus of this paper was to compare healthcare resource use between the two groups using the third-party payer perspective. Data were collected at baseline and at 8 and 12 weeks after baseline. Healthcare resources were priced at Medicare payment levels for services and average wholesale price for medications.
  
  
  RESULTS
  Average costs of visits, procedures, and medications were similar between groups. Average costs of hospitalizations and tests, and therefore total costs, were half as much in the Brain Fitness group as compared to the active control group, but this difference was not significantly different from zero (p = 0.24).
  
  
  CONCLUSIONS
  Larger randomized controlled trials are needed that include analyses of program costs and costs associated with medical and non-medical services in order to fully evaluate efficacy of this intervention.
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI 48109, USA. spressle@umich.edu
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Pressler
authors.forename: Alison
authors.initials: A
authors.lastname: Martineau
authors.forename: Judith
authors.initials: J
authors.lastname: Grossi
authors.forename: Bruno
authors.initials: B
authors.lastname: Giordani
authors.forename: Todd M
authors.initials: TM
authors.lastname: Koelling
authors.forename: David L
authors.initials: DL
authors.lastname: Ronis
authors.forename: Penny L
authors.initials: PL
authors.lastname: Riley
authors.forename: Cheng-Chen
authors.initials: CC
authors.lastname: Chou
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sullivan
authors.forename: Dean G
authors.initials: DG
authors.lastname: Smith
mesh_terms: D019411:Clinical Laboratory Techniques / Q000191:economics / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000191:economics* / Q000534:rehabilitation; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods; D010865:Pilot Projects; D012648:Self Care
keywords: Cognition; Cost; Healthcare resource use; Heart failure; Memory